ISSN 2398-2950      

Liver: trauma

ffelis

Synonym(s): Hepatic trauma


Introduction

  • Cause: common injury is blunt trauma, eg falls, gunshot wounds and road traffic accidents.
    In all cases of traumatic injury warn owner of potential complications at time of injury.
  • Occasionally a fractured rib lacerates liver.
  • Signs: concurrent injuries to other abdominal viscera; related to degree of hemorrhage: a few ml of blood loss to a massive exsanguination   →   shock.
  • Diagnosis: radiography, ultrasonography.
  • Treatment: fluid therapy, abdominal wrapping for shock; failure to improve the circulatory status will require surgical exploration of the peritoneal cavity.
  • Prognosis: good if no complications.

Pathogenesis

Etiology

  • Blunt trauma, eg falls from heights, road traffic accidents.
  • Penetrating bite wounds.
  • Gunshot wounds.

Pathophysiology

  • Trauma to the rib cage   →   fractured rib   →   lacerate liver lobe   →   hemorrhage.
  • Trauma   →   liver rupture   →   hemorrhage, massive ex-sanguination often associated with an avulsion of a hepatic lobe from the vena cava.
  • Hepatic injury   →   ischemia to a portion of the liver   →    devitalized tissue   →    bacterial proliferation   →   local peritonitis Peritonitis or liver abscess.
  • May be other associated injuries, eg pancreatic Pancreas: trauma, thoracic injuries Thorax: trauma etc.

Timecourse

  • Usually acute though may be several days with gall bladder injuries.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Streeter E M, Rozanski E A, Laforcade-Buress Ad et al (2009) Evaluation of vehicular trauma in dogs: 239 cases (January-December 2001). JAVMA 235 (4), 405-408 PubMed.
  • Boysen S R, Rozanski E A, Tidwell A S et al (2004) Evaluation of a focused assessment with sonography for trauma protocol to detect free abdominal fluid in dogs involved in motor vehicle accidents. JAVMA 225 (8), 1198-1204 PubMed.
  • Vinayak A, Krahwinkel D J (2004) Managing blunt trauma-induced hemoperitoneum in dogs and cats. Comp Contin Educ Pract Vet 26 (4), 276 VetMedResource.

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